COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

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<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006 How do we engage the patient? Respect is everything! • Establish rapport-therapist as social reinforcer: disrespect gets you no where • Providing hope: empowering the patient • Motivating attendance with snacks, etc • Set the contract: expectations, obligations, expectable outcomes • Therapist techniques and tools: GRACE, OARS and 12 roadblocks to communication Ordering, threatening, giving advice, arguing, preaching, judging, praising, shaming, interpreting, consoling, probing, withdrawing What do we assess? Where I am, and where I want to be? • Treatment Goals Card Sort: assesses behavioral excesses, deficits and assets. • Functional Analysis: clarifies problem behaviors Biologic/Social/interpersonal consequences (short- & long-term). Social mediators of consequences-who, when, where.. Benefits and costs of behavior and change. New problems resulting from change. • Motivational Analysis Incentives/disincentives: what, who, how often Supports and impediments to change. How do we motivate for change? A time of reckoning. • Look for the Gap: what you say versus what you do. • Crossing the gap: clarify goals, decision analysis, and cost/benefits. • Structured techniques & tools. “What If” exercises. Decisional Balance Worksheet • Identify alternatives & consequences. • Feedback of treatment options and current strengths, deficits, impediments and supports. • Dealing with resistance: no arguing, what if? How do we change behavior? How do I get there from here? ● Select/establish simple and achievable goals. • Review gap, cost/benefits, positive supports • Explore realistic alternatives to drug use • Identify simple behavioral tactics to minimize impediments and maximize supports. • Techniques & Tools Behavioral rehearsal Instruction • Review plan for discharge • Take off on a position for change: certificates, copy of treatment goals, positive experience in treatment. How do we maintain changes? Think of me when I’m gone! How do we assure the plan is achieved in the outpatient environment? • Coordinate aftercare: patients have option to see current FASST therapist for OPT • Empower the patient: survival bible, copies of treatment goals, etc. • Identify supportive caregivers and/or mentors • Train caregivers and/or mentors • Mobilize community/ Community interventions • Community education 2
12 Roadblocks of Communication 1 Ordering, Directing or Commanding. Here a direction is given with the force of some authority behind it. There may be actual authority (as with a parent or employer), or the words may simply be phrased in an authoritarian way. Some examples: Don’t say that. You’ve got to face up to reality. Go right back there and tell her you’re sorry! Warning or threatening. These messages are similar to directing, but they also carry an overt or covert threat of impending negative consequences if the advice or direction is not followed. It may be a threat that the individual will carry out, or simply a prediction of a bad outcome if the other doesn’t comply: You’d better start treating him better or you’ll lose him. If you don’t listen to me you’ll be sorry. You’re really asking for trouble when you do that. Giving advice, making suggestions, providing solutions. Here the individual draws on her or his own store of knowledge and experience to recommend a course of action. These often begin with the words: What I would do is… Why don’t you… Have you tried… Persuading with logic, arguing, lecturing. The underlying assumption in these is that the person has not adequately reasoned it through and needs help in doing so. Such responses may begin: The facts are that… Yes, but… Let’s reason this through. Moralizing, preaching, and telling them their duty. An underlying moral code is invoked here in “should” or “ought” language. The implicit communication is instruction in proper morals. Such communication might start: You should… You really ought to… It’s your duty as a _____ to… Judging, criticizing, disagreeing, blaming. The common element here is an implication that there is something wrong with the person or with what he or she has said. Note that a simple disagreement is included in this group. It’s your own fault. You’re being too selfish. You’re wrong. Agreeing, approving, praising. Some people are surprised to find this included with the roadblocks. This kind of message gives a sanction or approval to what has been said. This, too, stops the communication process and may also imply an uneven relationship between speaker and listener. True listening is different from approving and does not require approval. I think you’re absolutely right. That’s what I would do… You’re a good _____. Shaming, ridiculing, name-calling. Here the disapproval is more overt, and is directed at the individual in hopes of shaming or correcting a behavior or attitude. That’s really stupid. You should be ashamed of yourself. How could you do such a thing? Interpreting, analyzing. This is a very common and tempting one for counselors: to seek out the hidden meaning for the person and give your own interpretation. You don’t really mean that. Do you know what your real problem is? You’re just trying to make me look bad. Reassuring, sympathizing, consoling. The intent here is usually to help a person feel better. What’s wrong with that? Nothing, perhaps, but it’s not listening. It meets the criterion as a roadblock because it interferes with the spontaneous flow of communication. Examples: There, there, it’s not all that bad. I’m sure things are going to work out all right. Don’t worry; you’ll look back on this in a year and laugh. Questioning, probing. People also mistake asking questions for good listening. Here the intent is to probe further, and find out more. A hidden communication from the questioner, however, is that he or she will be able to find a solution as soon as enough questions have been asked. Questions interfere with the spontaneous flow of communication, diverting it in directions of interest to the questioner but not, perhaps, to the speaker. What makes you feel that way? How are you going to do that? Why? Withdrawing, distracting, humoring, and changing the subject. Finally, this very obvious roadblock is an attempt to “take the person’s mind off it.” It directly diverts communication, and underneath implies that what the person was saying is not important or should not be pursued. Let’s talk about that some other time. That reminds me of the time… You think you’ve got problems, let me tell you… I hear it’s going to be a nice day tomorrow. Look on the bright side of things….
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Program Description: The Commonweal
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Conference Information: The Pennsyl
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MONDAY May 15 th , 2006
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Monday Morning Plenary Session “S
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COSIG Co-Occurring Disorders Confer
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Page 77 and 78: 3 G.R.A.C.E. G- For Gap. Often our
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Page 81 and 82: 7 Overall, what do you gain by drug
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Page 122 and 123: TABLE OF CONTENTS Purpose of the Ca
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confidentiality in substance abuse
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Task 4 - Recognize signs and sympto
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individual’s needs and circumstan
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and community resources and service
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3. Social supports and networks for
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COUNSELING Task 1 - Provide a safe,
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CASE MANAGEMENT information. Task 1
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ensure continuity of care whenever
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disciplinary codes of ethics and st
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2. Effective public relations techn
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2. Eliciting accurate evaluation da
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2. There are seven elements in the
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elationship is established with the
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In taking the test, you may find it
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REFERENCES The following resources
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Other Drug Abuse Counselors. Columb
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Stern, T., Herman, J., & Slavin, P.
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2004 PA Certification Board (PCB).
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Prochaska, J.O. & DiClemente, C.C.,
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M12: An Overview of Adolescents and
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G. Benson, 2004 G. Benson 2004 COSI
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M13: Tri-Recovery Process: Improvin
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M15: TIP 42 Treatment for Persons w
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M16: Housing Implications for the O
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DRAFT - Community Based and Recover
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are perceived as necessary for stat
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esponsibility shared with consumers
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or provided at other rehab programs
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Supportive housing is a successful,
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Living on the Edge: Substance Use a
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M26: Dual Recovery: 12-Step Program
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Using Dialectical Behavior Therapy
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Using Dialectical Behavior Therapy
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TUESDAY May 16 th , 2006
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Article by Kenneth Minkoff, MD and
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RESOURCE BIBLIOGRAPHY (2005) 1. Ame
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38. Foundation Associates, Making M
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71. Minkoff K & Cline C, Developing
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co-occurring psychiatric and substa
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T31: Implementing Evidence-Based Pr
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T32: Berks County Adolescent Pilot
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T35: CCISC Implementation in Pennsy
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Volume 1, Issue 5 The Trainers meet
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Volume 1, Issue 1 BLAIR COUNTY’S
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Volume 1, Issue 1 Vision/Mission CO
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Volume 1, Issue 1 3. The population
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Volume 1, Issue 1 Complete
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Volume 1, Issue 1 The forgoing Cons
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Volume 1, Issue 1 Language for Inte
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Volume 1, Issue 1 Language for Inte
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T36: The Co-Occurring Distinction:
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Integration or Occupation? •QUEST
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Coming to a Balance “Rather shall
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T41: Offering Positive Incentives t
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Motivational Incentives for Enhance
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T43: Prison to Community: Reducing
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T45: Workforce Issues and Co-occurr
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T46: Creation of Local Housing Opti
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Fetal alcohol spectrum disorders fo
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MY 9-YR-OLD SON’S HISTORY OF MEDI
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Don’t Ask My Child to Fly Bruce R
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1 Multisystemic Therapy MST Model H
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3 NCFAS RESULTS: Adolescents & Pare
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Adelphoi Village Multisystemic Ther
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DISCHARGES PER AGENCY TOTAL DISCHAR
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T53: Using Change Theory to Assess
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The following questionnaire is desi
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THE STAGES OF CHANGE APPLIED TO COU
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T55: Creating Co-Occurring Centers
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12. What is the diagnosis: |___| 1
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Fact Sheet A Project to Establish A
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Planning and Implementing a Welcomi
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All organizations signing this memo
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3. Region I organizations will assi
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e) Link organizations with websites
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Planning and Implementing a Welcomi
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Welcome to the Johnson Institute ht
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johnsoninstitute.com - History http
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johnsoninstitute.com - President's
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MISA PILOT TAKES FLIGHT: A PILOT AP
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In Flight Changes for COD in Washin
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Crisis & Counseling Centers Co-occu
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Fact Sheet A Project to Establish A
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Mental Health Network Co-Occurring
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100% Treatment Team Improvement in
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T67: Antisocial Personality Disorde
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Wednesday Morning Plenary Session
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Cultural Clashes in Co-Occurring Di
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W72: Use of Animal Assisted Therapy
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W74: Therapy for Women Facing Traum
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HIEN, COHEN, MIELE, ET AL. for the
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HIEN, COHEN, MIELE, ET AL. TABLE 2.
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HIEN, COHEN, MIELE, ET AL. TABLE 4.
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W75: The MISA/COD Pilot Projects: L
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THE BEAVER COUNTY MODEL • Targets
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Additional Information Contact: Nan
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W81: The Pennsylvania COSIG Evaluat
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W83: Beaver County Forensic COD Ini
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W84: Improving Assessment and Treat
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Improving Assessment and Treatment
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W86: Fairweather Lodge - An Evidenc
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Housing, Employment, Social and Aut
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Principle VI. Successful Lodges res
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Fidelity to Autonomy Principles 1.
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W87: Physical Disorders and Persons
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W96: Stigma & Co-occurring Disorder
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